J9074
J9074 – Inj, cyclophosphamd, sandoz · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 3 NDCs crosswalked per 5 MG $3.438/unit ASP+6%
📋 J9074 summary
J9074 is a HCPCS Level II J-code used to bill cyclophosphamd, sandoz, billed per 5 MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Brand names associated with J9074: Cyclophosphamide(J9074)
Code J9074
Billing unit 5 MG Payment limit $3.438/unit NDC-Crosswalk 3
Quarter Q3 2026
RxCUI Atlas Trace the drug concept →
⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.
🗂️ Key billing facts
HCPCS codeJ9074
DescriptorInj, cyclophosphamd, sandoz
Billing unit5 MG
Payment limit / unit$3.438
Est. ASP / unit$3.243 est.
Mapped NDCs3
Data periodQ3 2026
Last updated2026-08-20
💊 About Cyclophosphamide DRUG GUIDE
Cyclophosphamide is used to treat many types of cancer in adults and children, including malignant lymphomas (such as Hodgkin's disease and Burkitt's lymphoma), multiple myeloma, several forms of leukemia, breast cancer, ovarian cancer, neuroblastoma, retinoblastoma, and advanced mycosis fungoides (a type of skin lymphoma).
It is often given alongside other chemotherapy drugs rather than on its own.Oral and injectable powder formulations (but not the Cyclophosphamide Injection solution concentrate) are also approved for minimal change nephrotic syndrome — a kidney condition — in children who have not responded well to, or cannot tolerate, steroid therapy.
The injectable solution concentrate is approved for adult patients only due to its alcohol content, and is not approved for use in children.
Clinical overview from our editorial drug guide for Cyclophosphamide. For billing reference, see the sections above.
🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026
📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$3.438
Est. ASP / unit
$3.243 est.
Est. after 2% sequester
$3.369
HCPCS dosage
5 MG
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J9074 = 5 mg. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.
🔁 NDCs that bill under J9074 WITH EST. MEDICARE PAY
3 NDCs map to J9074. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($3.438/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00781-3528-10 | Cyclophosphamide 500 mg/5mL INJECTION, SOLUTION, CONCENTRATE | Sandoz | 1 VIAL, MULTI-DOSE in 1 CARTON (0781-3528-... | 500 mg/5mL | 100 | $343.80 | — | ● Active | CMS ASP |
| 00781-3529-10 | Cyclophosphamide 1000 mg/10mL INJECTION, SOLUTION, CONCENTRATE | Sandoz | 1 VIAL, MULTI-DOSE in 1 CARTON (0781-3529-... | 1000 mg/10mL | 200 | $687.60 | — | ● Active | CMS ASP |
| 00781-3530-10 | Cyclophosphamide 2000 mg/20mL INJECTION, SOLUTION, CONCENTRATE | Sandoz | 1 VIAL, MULTI-DOSE in 1 CARTON (0781-3530-... | 2000 mg/20mL | 400 | $1,375.20 | — | ● Active | CMS ASP |
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$344K
Claims
432
Beneficiaries
241
Spend / beneficiary
$1,427.52
Spend / claim
$796.37
Trend by period
Where J9074 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #475 of 824
#470
OASIS BURN MATRIX** Q4103
$362.6K
#471
METHYLPREDNISOLONE S... J2919
$358.5K
#472
BICILLIN L-A J0561
$356.8K
#473
ORBACTIV J2407
$354.4K
#474
SUBLOCADE(Q9992) Q9992
$345.4K
#475
CYCLOPHOSPHAMIDE(J90... J9074
$344K
#476
IODIXANOL(Q9966)* Q9966
$341.3K
#477
YESINTEK Q5100
$340.6K
#478
ETOPOSIDE J8560
$337.5K
#479
CYCLOPHOSPHAMIDE(J90... J9076
$332.9K
#480
CIMERLI Q5128
$331.8K
Total claims — #468 of 824
#463
LIDOCAINE HCL IN 5%... J2002
477
#464
VINORELBINE TARTRATE J9390
477
#465
VPRIV J3385
474
#466
ELITEK J2783
468
#467
ARSENIC TRIOXIDE* J9017
453
#468
CYCLOPHOSPHAMIDE(J90... J9074
432
#469
MOZOBIL* J2562
424
#470
ADVATE* J7192
424
#471
DEMEROL* J2175
408
#472
VINBLASTINE SULFATE J9360
407
#473
DAXXIFY J0589
404
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $344K | 241 | 432 | $1,427.52 | $796.37 |
| 2025 (Q1-Q4) | $2.18M | 937 | 2,546 | $2,324.44 | $855.46 |
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.
📈 Medicare Part B claims detail CMS PSPS · 2024
Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$839.7K
Medicare paid
$651.5K
Submitted services
209,251
Denial rate
4.3%
Allowed / service
$4.19
Submitted charges
$2.6M
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.
🗃️ Data sources & freshness
Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Not available in current dataset
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk
3 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Not available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.
⚠️ Practical billing caveats
- A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
- Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
- Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
- Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
- The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
- Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.
❓ J9074 billing FAQ
What is HCPCS code J9074?
J9074 is a HCPCS Level II J-code used to bill Inj, cyclophosphamd, sandoz under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J9074?
One unit of J9074 represents 5 MG. Report the number of units equal to the dose administered divided by 5 MG.
How many units of J9074 should I bill?
Divide the dose administered by the code's unit size (5 MG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J9074?
The Medicare Part B payment limit is $3.438 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $3.369 per unit. Payment limits are revised quarterly.
Which NDCs bill under J9074?
3 NDCs currently map to J9074 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J9074 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.